Change in Stigma Severity Following Psychiatric Hospitalisation: A Study of Associated Clinical Factors in an Indian...

While stigma surrounding mental illness continues to affect management, there are hardly any studies reflecting any change following psychiatric admission. We aimed to examine how self-stigma changes during treatment in an inpatient setting and how it relates to improvements in symptoms and functioning.

We analyzed stigma, depression, anxiety, stress, insight, well-being, functioning, and disability in 100 consecutive patients at admission and discharge in a psychiatric hospital in Kerala.

At admission, 34.5% (confidence interval [CI]: 24.5-45.7) of patients reported self-stigma, which decreased to 23.2% (CI: 15.1-32.9) at discharge; the stigma score decreased from 17.1 ± 6.6 to 14.9 ± 4.7 (p < .005). However, stigma levels did not change between admission and discharge for most (68.3%) patients; 87.5% had minimal stigma, with no scope for further reduction. In a minority (7.3%), stigma severity increased. Stigma correlated positively with depression, anxiety, functioning, and insight, and negatively with age and well-being at admission; and at discharge, positively with stress. Patients reporting stigma had higher depression, anxiety, insight, and poorer well-being both at admission and discharge.

Most patients had a lower level of stigma; average stigma severity decreased during psychiatric admission; however, in a minority, it increased. While usual care was beneficial, the effectiveness of a proactive approach to stigma reduction warrants further study.